「」……耳なれない言葉であるが, よく考えてみるともともと社会から遮断された学問分野の方がはるかに少ない.自然科学系でも, 農学部の農経, 林学, 工学部の衛生工学, 医学部の衛生, 公衆衛生学など.環境科学を専攻する独立大学院すらある.そこで北大での第99年会を機会に薬学の社会性について研究し, 考えてこられた方々にお集まりいただき, 手さぐりではあっても研究の必要性について話し合っていただいた.

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 Among private Universities of Pharmacy in Japan, Kyoritsu University of Pharmacy was the first to introduce courses in social pharmacy in 1991. Social pharmacy is a discipline driven by social needs. By studying the relationship between pharmacy and society, particularly through case studies, the impact of drugs and changes in societal expectation of them, as well as through historical background studies and surveys of current trends, this discipline acts to determine the roles of pharmacists and pharmacies expected by society. Social pharmacy requires a basic knowledge of pharmaceutical science, but an understanding from economic viewpoints of the current systems and structures in which healthcare functions is important as well. Once these are understood, the goal is to identify social problems, and to create and apply models for their resolution which connect pharmacy and society. So far, social pharmacy has played an important role in training programs for community-based pharmacists essential for a hyper-aged society, for community pharmacies' health management programs aimed at promoting the health of residents, and educational programs for elementary and middle school children.

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In this study, we aim to clarify the impact of drug abuse prevention education and the experiences of people who have stayed in countries that are tolerate marijuana use for recreational purposes on their beliefs regarding the relaxation of the Cannabis Control Law. On May 12-13th, 2022, a web-based questionnaire survey was presented to Japanese nationals aged 18-41 years who had spent at least 5 days in a marijuana-tolerant country. Univariate and multiple logistic regression analyses were conducted with “Views on the Relaxation of the Cannabis Control Law” as the objective variable. A total of 160 respondents (45.6% male) responded, of whom 33.8% supported relaxing the law for the consumption of recreational cannabis in the form of food, drink, or smoke. Additionally, 27.5% of the respondents had encountered recreational cannabis through some channel during their stay. Multiple logistic regression analysis revealed a significant positive association between idea of supporting the relaxation of the law and the tolerance of the image of the physical and mental effects of recreational cannabis and the social effects of its distribution. Neither knowledge of marijuana and drug abuse nor the experience of being encouraged to use it during their stay were significantly associated. The study suggested that in order to deter marijuana use during stays in such countries, it is necessary not only to improve knowledge, but also to foster imagination and the ability to think and predict the physical and social effects of its use.

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The prevalence of seasonal allergic rhinitis (hereinafter “hay fever”) is increasing annually. While self-medication with over-the-counter (OTC) drugs is growing, some hay fever patients also use OTC drugs alongside medical visits. Issues arising from co-administration, such as excessive dosing and reduced quality of life (QOL) due to drowsiness, have been highlighted. However, no research has investigated the factors contributing to the concomitant use of prescribed and OTC drugs. Therefore, this study examined the following three patient groups: those using only prescribed drugs, those using only OTC drugs, and those using a combination of both. Initial analyses compared adherence, overuse extent, QOL (as measured by the Japanese Rhino-conjunctivitis Quality of Life Questionnaire [JRQLQ]), treatment satisfaction, lifestyle habits, and health literacy (as measured by the Communicative and Critical Health Literacy Scale [CCHL]) among the groups. Subsequently, a multinomial logistic regression analysis focusing on combination users identified factors associated with co-administration. The results revealed that combination users exhibited lifestyle issues and lower QOL compared to those using prescribed or OTC drugs only, although differences in CCHL were not significant. Furthermore, co-administration was linked to social life-related JRQLQ and excessive usage during symptom onset. In conclusion, patients with hay fever should avoid the concurrent use of prescribed and OTC drugs. Co-administration may not necessarily improve symptoms and might even lead to overuse risks. Thus, patients should be guided to consult medical professionals before purchasing OTC drugs, and lifestyle improvements should be emphasized as well.

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Objectives: At the pharmacy, information obtained from patients by pharmacists is often inadequate. To motivate patients to provide information, we explored factors influencing their willingness to provide information and evaluated changes in their intention through informing of pharmacists’ contribution to pharmacotherapy. Methods: Four videos regarding pharmacists’ contribution to pharmacotherapy were created. A total of 600 participants who regularly visit pharmacies were targeted. One hundred and fifty participants watched one of the four videos and answered questions about their willingness to provide information to pharmacists before and after watching the videos. Key findings: The positive factors influencing the willingness to provide information were trust in the pharmacist and knowing pharmacists’ contribution to pharmacotherapy. After watching any of the videos, the willingness to provide information increased (P<0.001). In addition, when the participants were divided into two groups based on whether or not they had already known about the video content, the willingness of the participants in both aware and unaware groups to provide information improved (P<0.001). The factors that improved willingness in participants with low willingness were an explanation from their family pharmacist and trust in the pharmacist. On the contrary, having diabetes was a restraining factor. Conclusion: The study revealed that publicizing pharmacists’ contribution to pharmacotherapy increases the patients’ willingness to provide information to the pharmacist, regardless of their original level of awareness of the contribution. Furthermore, patient-pharmacist relationships based on trust in the pharmacist were influential.

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Objective: The proportion of young patients in Japan in whom generic drugs are used is lower than that of other age groups. To promote the use of generic drugs in young patients, we need to change the parents’ attitude toward generic drugs. Therefore, we aimed to contribute to the maintenance and reform of the Japanese social security system by investigating the effects of parent’s sex, patient’s age, and use of the children’s medical expense subsidy system on the selection of generic drugs. Method: We surveyed parents of young patients (<20 years) whose prescriptions were filed at pharmacies from November 25 to December 1, 2019. Results: Of the 712 valid questionnaires retrieved, 74.3% of parents reported using generic drugs for young patients. Approximately 92.2% of the parents reported using the children’s medical expense subsidy system. The highest (51.4%) reason for switching to generics was “recommendation from a pharmacist, etc.” Cognitive methods using online content were higher among male parents than among female parents (28.0% vs. 11.5% ; P<0.001). Regarding catchphrases that make them want to hear, female parents were more likely to hear about generic drugs than male parents were if the catchphrases quality and safety were used (38.1% vs. 23.8% ; P＝0.007). Compared to parents of 7-19-year old children (6.8%), parents of 0-6-year old children (13.1%) reportedly switched to generic drugs because they were easier to ingest (P＝0.022). Conclusion: Recommendations from medical professionals such as pharmacists are effective in convincing parents of young patients to switch to generic drug use. To promote the use of generic drugs in young patients, in addition to explaining and publicizing its financial benefits, pharmacists need to explain the added value of generic drugs such as the ingenuity of its dosage form. In addition, it is essential to adopt a multifaceted approach that considers the parents’ background including (1) publicity using the internet for male parents, (2) reaching out to female parents with preschool children, (3) increasing publicity using tickets for children’s medical expenses subsidy system, and (4) drug education that matches the growth of children.

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The import of medicines for personal use by physicians for aesthetic-related medical treatments in Japan is limited to cases such as a medical emergency and when substitutes are unavailable in the country. However, the real reasons why doctors import these products and their safety have not been investigated. Therefore, to contribute to future countermeasures, we investigated the circumstances for personal import of these medicines. We found that 60 of 177 (33.9%) physicians in the cosmetic surgery, plastic surgery, and dermatology departments had experience of importing medicines. Although only medically urgent medicines can be imported, 11.7% of physicians who imported medicines cited price differences between Japan and other countries as the reason for importing. Botulinum toxin injections (25.0%) were the most commonly imported medicines. Furthermore, 11 physicians (18.3%) responded that there was some defect in the products. This proportion was significantly higher among physicians who experienced a product efficacy or safety issue (68.8%) than among those who had never experienced it (0.0%) (P<0.001). This survey revealed that the import of aesthetic-related medicines that are not suitable for personal import is rampant. In addition, there could be an association between the defects of these products and their efficacy/safety. Therefore, to prevent health damage caused by these medicines, it is important to strengthen the regulatory system for collecting and providing information to ensure thorough confirmation (regarding specifications and package insert) at the time of delivery and use in patients and to tighten administrative checks about reasons for import.

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Although the fees for the implementation of antimicrobial stewardship (AS addition) were newly established in the 2018 revision of medical fees, more detailed activities and issues of pharmacists at facilities calculating AS addition have not been clarified so far. Therefore, to understand the current status of AS activities and problems, we conducted a questionnaire survey of facilities that calculate the additional fee for infection prevention measures 1 and investigated whether there are differences in AS activities between facilities where pharmacists are full-time employees and facilities where non-pharmacists are full-time employees. The results showed that the number of antimicrobial agents used by full-time pharmacists was larger than that by non-pharmacists. In addition, the frequency of AS was lower for non-full-time workers than for full-time workers, with most full-time workers performing AS every day, while non-full-time workers performing AS two to three days a week. In addition, non-full-time workers lacked human resources and work time, and did not have sufficient work materials. The survey revealed that AS activities’ current status and problems differ between full-time and non-full-time employees.

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Anxiety and difficulty in administering medication to nursery school children has been reported among nursery school teachers. This study aimed to elucidate these issues and explore the possibility of pharmacist support and collaboration. We conducted a postal survey in September 2019 among nursery schools in Tokyo that are categorized as government-authorized schools, certified childcare centers, and prefectural governor-certified schools. A total of 1,537 schools responded to the self-report questionnaires (response rate: 41.2%), and 1,533 responses were analyzed. Of these, 1,488 schools were asked if they would accept requests to administer medication to their school children, and 60.1% of the nursery schools responded that their staff (including teachers and nurses) found it difficult to administer medication. The issues identified included psychological burdens (such as nervousness and pressure about giving the correct medication), staff shortage, insufficient time with the children, and human factors (such as personal perceptions of medication). Additionally, excessive requests to administer medication, caregiver behavior such as low awareness of children’s health and appropriate medication, and poor medication adherence at home were identified as issues. It was suggested that pharmacists could help alleviate these problems through their daily work at the pharmacy. Approximately 49-62% of schools responded that they would request the collaboration of community pharmacists to conduct training sessions for nursery school staff, provide health support for caregivers, and provide general health and medication consultations. The collaboration between nursery schools and community pharmacists may gain importance in the future.

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A questionnaire survey was conducted to investigate the use of goreisan for headaches caused by weather and atmospheric pressure changes, and to clarify issues in promoting treatment with goreisan. The subjects were men and women in their 20s to 40s who developed headaches due to changes in weather and atmospheric pressure. Medication was used by 58.0% of the migraine group and 42.5% of the other headaches group. Among them, 27.5% of the migraine group and 15.1% of the other headaches group had used goreisan. Regarding the method of use of goreisan, the most common answer for the migraine group was “used after feeling a sign that headache is likely to occur,” whereas for the other headaches group, the most common response was “used after headache has occurred.” In the migraine group, the most frequent premonitory symptom was “stiffness in the shoulders and neck.” More than 80% of both groups were satisfied with the use of goreisan. In addition, 77.8% of migraine group and 59.5% of the other headaches group of those who had never used goreisan answered that they would like to use goreisan for headaches caused by weather or atmospheric pressure changes in the future. As a reason for not wanting to use goreisan, over half of both groups answered that they did not like the taste of herbal medicines. It is necessary to offer tablets to patients that do not like the taste.

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In the United States, the concepts of “Pay For Performance” and “Value-Based Health Care” were introduced, and it has been taken up as the way forward for the American health care systems. As one of the measures, an Accountable Care Organization (ACO) was included in the federal Affordable Care Act, and are being promoted for the purpose of balancing cost savings and good quality assurance in the healthcare field. In this manuscript, we provide an overview of the system of ACO, which is one of the value-based health care systems and was introduced with the aim of balancing cost savings and good quality assurance of medical care, and also focus on the role of pharmacists in ACO and summarize their roles they are executing and expected. Furthermore, we discuss on what we should learn from the United States in considering the ideal medical care systems in Japan.

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The significance of lifelong learning is increasing in Japan’s aging society. The purpose of this study is to clarify the factors that affect the participation in lifelong learning of the elderly people in relation to subjective well-being, physical activity/exercise, and social activity. We conducted a questionnaire survey among lifelong learning participants. The contents of the questionnaire items were scored and the influence of the number of years of participation in the lifetime learning was examined using confirmatory factor analysis. There were 207 participants with an average age of 73.2 years old. In terms of health and life, most of the participants answered positively. In terms of coping with stress, many respondents had that coping strategy. Their nutritional intake and exercise habits were good. They had a high rate of health check-ups, were highly interested in disease prevention and paid attention to their health management. From the exploratory factor analysis of the questionnaire results, the five common factors behind lifelong learning participants were “subjective well-being,” “physical activity/exercise,” “subjective view of health,” “nutrition/diet,” and “social activity.” There was a negative relationship between “years of participation in lifelong learning” and “subjective well-being,” and a positive relationship between “physical activity/exercise” and “social activity” of these latent variables. In conclusion, many of the lifelong learning participants were highly conscious of their health, had acquired appropriate habits in terms of exercise and nutrition, and had a high subjective well-being. The elderly’s continuous participation in lifelong learning is beneficial for “physical activity/exercise” and “social activity.”

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